How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $120.23 Median $165.96 Typical High $194.98 | Professional | 32 · Mandated service | $120.23 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,949.84 Typical High $2,454.71 | Facility | None | $363.08 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $338.84 | Professional | None | $114.82 | $134.90 | $338.84 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,128.61 | Facility | None | $1,096.48 | $2,454.71 | $5,128.61 |
United Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $165.96 | Professional | None | $89.13 | $125.89 | $165.96 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $21.38 |
Where Alabama sits
The same service costs 12.9 times more in Arkansas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alabama· 6th of 51
$1,259
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.